1991 NATIONAL HEALTH INTERVIEW SURVEY (PRETEST)

Forms and Documents

Document Name	Status

No forms / supporting documents in this ICR. Check IC Document Collections.

IC Document Collections

IC ID	Document Title	Status
110970	1991 NATIONAL HEALTH INTERVIEW SURVEY (PRETEST)	Migrated

ICR Details

OMB Control No: 0920-0259	ICR Reference No: 199004-0920-004
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: HHS/CDC	Agency Tracking No:
Title: 1991 NATIONAL HEALTH INTERVIEW SURVEY (PRETEST)
Type of Information Collection: New collection (Request for a new OMB Control Number)	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 07/09/1990
	Date Received in OIRA: 04/10/1990
Terms of Clearance: This information collection request is approved until 8/31/90 under the following conditions: 1) HHS informed OMB that it needed to significantly reduce the sample size of the pretest because it did not allow enough time for OMB review. HHS should ensure that the pretest size is sufficient to accomplish the purposes of the pretest. 2) HHS will provide background materials and full explanations of how the topics for the year 2000 objectives supplement fit into HHS' approach to the year 2000 objectives and how the data collected throug the supplement will contribute to measuring achievement of objectives distinct from other Department surveys. 3) Question 7 on the year 2000 supplement should be dropped because of the unclear link to the objectives and its very narrow scope if its purpose is to measure knowledge and behavior vis-a-vis food and the risk of food-borne illness. Other questions in this supplement should be revise to more closely reflect other comparable Federal surveys e.g., the Diet and Health survey, or be dropped as duplicative. 4) The illicit drug use supplement should be revised to include all suggested questions from ONDCP agreed to by HHS for the pretest. HHS should also reexamine the format of the drug supplement with particula attention to the use of a checklist format for all questions regarding EVER using... (remarks continued on a separate sheet)

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	08/31/1990	08/31/1990
Responses	340	0	0
Time Burden (Hours)	475	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: THE NATIONAL HEALTH INTERVIEW SURVEY (NHIS) IS AN ON-GOING SURVEY OF T CIVILIAN, NONINSTITUTIONALIZED POPULATION THAT MONITORS THE NATION'S HEALTH. THE NHIS CONSISTS OF A CORE AND ANNUALLY CHANGING SUPPLEMENTS THE FOLLOWING SUPPLEMENTS ARE SCHEDULED FOR INCLUSION IN THE 1991 NHIS YEAR 2000 OBJECTIVES, ILLICIT DRUG USE, YOUTH RISK BEHAVIOR, INCOME. THIS REQUEST IS FOR THE PRETEST OF THE 1991 NHIS. THE RESULTS OF THE

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Authorizing Statute(s): None

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:

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Federal Register Notices & Comments

Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 1

IC Title	Form No.	Form Name
1991 NATIONAL HEALTH INTERVIEW SURVEY (PRETEST)

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ICR Summary of Burden

	Total Approved	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	340	0	0	340	0	0
Annual Time Burden (Hours)	475	0	0	475	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement:

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Annual Cost to Federal Government: $0

Does this IC contain surveys, censuses, or employ statistical methods? No

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? Uncollected

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? Uncollected

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? Uncollected

Is this ICR related to the Pandemic Response? Uncollected

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Common Form ICR:  No

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On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 04/10/1990

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